Off-pump surgery is associated with thyroid hormone changes similar to conventional surgical revascularisation. The data suggest that further studies into T3 administration during OPCAB may be warranted.
We have recorded auditory evoked potentials before and during cardiopulmonary bypass in 10 adult patients undergoing cardiac surgery under moderate hypothermia to 27-28 degrees C. The immediate effect of bypass was a small decrease in latency and increase in amplitude of the early cortical response. We also studied two adults and two children during profound hypothermia with circulatory arrest during cardiopulmonary bypass. Reduction in core temperature to 25 degrees C resulted in an increase in latency and amplitude of the brain stem responses; below this temperature the amplitude decreased but latency continued to increase until the auditory evoked response trace became completely flat between 21 and 19 degrees C. These changes were reversible on rewarming.
We conducted a postal survey of all National Health Service centres where cardiac surgery is performed. We requested information about the priming solutions and additives used in the cardiopulmonary bypass circuit, and specifically asked whether changes were made in priming solutions for diabetic patients. Hartmann's solution was used by 63% of respondents, either alone or mixed with colloid. Heparin was added to the prime by 89% of respondents. Only two centres and one anaesthetist at a third centre altered the prime for diabetic patients.
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